Healthcare Provider Details

I. General information

NPI: 1205409745
Provider Name (Legal Business Name): HEIDI SEPTOR APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 PATTERSON RD
LAFAYETTE GA
30728
US

IV. Provider business mailing address

615 PATTERSON RD
LAFAYETTE GA
30728
US

V. Phone/Fax

Practice location:
  • Phone: 706-383-9792
  • Fax:
Mailing address:
  • Phone: 706-383-9792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number29931
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN277081
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: